Diagnostic Colposcopy in Adenocarcinoma of the Uterine Cervix

Although the incidence of adenocarcinoma of the cervix is 5% or more of all cases of cervical carcinoma, colposcopical studies of this lesion have never been reported systematically. We observed the colposcopic findings in 52 cases of cervical adenocarcinoma. The findings of cervical adenocarcinoma on colposcopy and of endometrial carcinoma on hysteroscopy were compared to confirm the diagnosis. In the early stages of cervical adenocarcinoma, papillary findings, transformation zone-like findings, a combination of these findings, granulation-like findings, and atypical vessels were observed. The lesions tended to bleed and secrete mucus, and root-like, wastethread-like, glomerular, tendril-like and corkscrew-like vessels were seen. In advanced stages, the lesion tended to be a necrotic mass with a collapsed surface. In some adenosquamous carcinomas, white epithelium, mosaic, and punctation were observed, but these were not seen in true adenocarcinomas. These surface and capillary characteristics resemble the hysteroscopic findings of endometrial carcinoma.